Pneumonia

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Signs and Symptoms

Symptoms of pneumonia vary in type and severity. In some cases, pneumonia produces mild symptoms and can go undetected or be mistaken for a severe cold or the flu (influenza). Elderly adults and other high-risk patients often show less obvious symptoms. Pneumonia can be life threatening and requires immediate medical care.

Pneumonia symptoms may appear suddenly or develop gradually over time. In general, symptoms depend on the age of the patient, the patient's overall health, and on the type of pneumonia.

The most common symptoms of pneumonia include:

• Below-normal body temperature (in older adults)
• Bluish coloring at the base of fingernails or of the lips
• Breathing problems, such as shortness of breath or painful inhalation
• Chest discomfort or pain
• Chills, shaking
• Coughing that may produce mucus (phlegm or sputum) that is thin and clear, or thick, yellow, green, or bloodstained
• Fatigue, tiredness, weakness, confusion
• Fever
• Rapid, shallow, or labored breathing
• Wheezing

Complications from pneumonia include scarring of lung tissue, which may have lasting effects on lung performance. Severe pneumonia also can cause a permanent weakening of air passages, which is called bronchiectasis. Bacterial pneumonia can spread to the (called blood poisoning, or sepsis), which can cause infections in other organs throughout the body. Meningitis is a possible complication of some types of pneumonia. In women who are pregnant, pneumonia is also associated with pregnancy complications involving the placenta.

Diagnosis

In many cases, pneumonia can be detected when a physician or other health care provider listens to the lungs with a stethoscope. In patients who have pneumonia, bubbling, crackling, or rumbling sounds may be heard. During physical examination, the patient's pulse, blood pressure, and breathing rate (breaths per minute) are measured and the level of oxygen in the blood may be tested with a simple device that fits snugly on the patient's finger.

The doctor may also ask questions about the patient's medical history to assess whether he or she is in a high-risk group and to determine if hospitalization may be required.

Diagnosis also involves determining the type of organism that is causing the pneumonia. A blood test may be performed to find out if bacteria or a virus is the cause.

A chest x-ray confirms a diagnosis of pneumonia and shows the affected area of the lung or lungs. If x-rays are not conclusive, a CT scan (computerized tomography) may be necessary. This test provides a more thorough image with the aid of a computer.

In some cases, it is necessary to admit a patient with pneumonia into the hospital. A thorough diagnosis can help determine whether hospitalization is necessary or home care would be adequate.

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